Studying the issues around the reporting of complete and quality data by private hospitals across New Zealand

Abstract

The policies of the Ministry of Health (MOH) around information collection and reporting are mainly focused on DHBs, who are allocated more than three quarters of the health funding and are responsible for planning, purchasing and providing health services within their regions (Ministry of Health, 2014a). The focus of the national health collections therefore, has always been to collect information about publically funded hospital services. Due to this weighted focus on public health service providers, over four hundred private hospitals across New Zealand (NZ) are under-represented in the National Minimum Data Set (NMDS) (Ross, 2012). MOH has a strong focus on providing New Zealanders with better health care through improved health information (Ministry of Health, 2013b), thus discharge data is extensively used by them in a number of applications to achieve this goal. For optimal success, it is vital for MOH to improve their own datasets and to ensure that their data is put to its best use by researchers and analysts. Part of this improvement requires a push towards ensuring better data collection from the private healthcare sector of NZ.

This study explored the views of private hospitals staff on improving the quantity and quality of the data reported by private hospitals across NZ. Semi structured interviews with 12 participants covering 32 private hospitals across NZ were conducted to collect the data. The data was analysed using thematic framework analysis.

The participants acknowledged that reporting full clinical information around each patient’s condition, especially for surgeries, would involve a change in traditional ways of entering and coding the clinical information. This is because their work is influenced by the mode of funding they receive and the type of treatment they provide to their patients. Most of the participants supported the idea of having full patient clinical information in the National Collections; however, since full patient diagnosis information is only usually accessible by the GP, specialist or the surgeon, they questioned how easily they as private hospitals could access and enter this information into their system with their current resources. Added to this is the fact that they do not employ clinical coders. This is because hiring the coders to record information which is not required for their funding or operational purposes is of no value to their business.

Different options for motivating the hospitals to maintain a minimal level of reporting were discussed. Participants emphasised the need for an increased level of collaboration from the Ministry in terms of feedback to their data as well as consideration of private hospitals as part of healthcare community. There was also a strong emphasis on the need to unify private and public sectors in order to reach the full potential of the whole healthcare sector. The participants’ view on the change included a desire to better understand the benefits to them from reporting which they hoped would lead to an improved level of engagement between MOH and the private surgical sector. Above all they saw a need to implement new ideas and methods of collaboration with the health sector as a whole that take into account both the service providers and patients.

The reporting of full datasets is both an issue of information availability and cost for private hospitals. Policy initiatives which combine private hospitals with the rest of the health sector are likely to meet with the challenges posed by the health improvement programs required to achieve improved healthcare for the whole nation.